An Evaluation of Breastfeeding Promotion Through Peer Counseling in Mississippi WIC Clinics

Objective: This study evaluates the effectiveness of a peer counseling program at increasing breastfeeding by participants in the Mississippi Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Methods: Data from the 1989–1993 Pediatric Nutrition Surveillance System were analyzed to compare breastfeeding rates in clinics with and without peer counseling programs. A questionnaire completed by program staff to describe the program in greater detail helped identify characteristics associated with greater success. Results: The incidence of breastfeeding rose from 12.3% to 19.9% in those clinics with peer counseling programs, but only from 9.2% to 10.7% in clinics without a program. Clinics that started a program earlier showed greater changes in breastfeeding incidence. However, the presence of lactation specialists or consultants in the clinic appeared to be more important than the presence of less-trained peer counselors. Peer counselors who spent more than 45 minutes per participant were more effective than those spending less time. Conclusions: The peer counseling program significantly increased the incidence of breastfeeding, particularly in clinics with lactation specialists and consultants. Success can be enhanced by ensuring that peer counselors spend a great deal of time with the participants.     

一年级工科大学生艾滋病/性病同伴教育的近期效果研究

为探讨在一年级工科大学生中开展预防艾滋病、性病同伴教育的可行性,１９９８ 年１０－ １１ 月,在某工科大学整群抽样选取１８３ 人为干预组,２０７ 人为内对照组;在另一所工科大学一年级抽取２０７ 人为外对照组。对干预组实施预防艾滋病、性病同伴教育,通过教育前后两次问卷进行近期效果评价。结果表明,干预组在教育后艾滋病、性病知识均分及问题答对率均有大幅度提高,与内、外对照组比较差异有高度显著性（ Ｐ＜ ０－０１）,而内、外对照组提高不明显。提示在一年级工科学生中开展艾滋病／ 性病／ 安全性行为同伴教育是可行而有效的     

The therapist's use of self and cultures in children's psychotherapy groups

This paper presents a model for understanding decisions that a therapist makes concerning the use of the self as a therapeutic tool in children's psychotherapy groups. The parameters within which a therapist uses self is directly related to the development of the group's culture. It is proposed that two complementary cultures develop within children's groups, one, indigenous peer culture, strictly of the children's making and the other, therapeutic group culture, created by the therapist in collaboration with group members. Having taken the time to learn a group's indigenous peer culture the therapist can use its metaphors to speak to the children in their own language; eventually it will be possible to engage them in collaboratively building a meaning system which is uniquely designed to address their psychotherapeutic needs. Initially, when indigenous peer culture is predominant, the therapist uses self more receptively in order to connect with the children through empathic immersion, holding intolerable affects and developmental time travel; as treatment progresses and a therapeutic group culture is slowly constructed, the therapist may use him/her self for more change directed interventions through role modeling, confrontation and self disclosure.Chief Psychologist and Coordinator, Children's Clinical Services, Brookline Community Mental Health Center and Instructor, Psychiatry (Psychology), Harvard Medical School and private practice in Brookline and Newton Massachusetts.     

对城市社区静脉吸毒人群AIDS相关行为及同伴教育的分析性研究

目的：分析社区静脉吸毒人群（IDUs）艾滋病相关行为特点及目前同伴教育的开展情况，提出建议。方法：以定性和定量相结合方法对某市城市社区静脉吸毒人群和疾控中心相关工作人员进行调查。结果：IDUs对艾滋病知识已有相当程度了解。共用注射器情况在减少。但仍有37．1％的对象近半年内共用过注射器。90％的对象有固定的活动圈子，圈子中毒友相处时间平均约4．5年，圈子中存在“核心人物”。在和固定性伴、非固定性伴、商业性性工作者发生性行为时，安全套的使用率分别为28．6％、53．3％、60．0％。结论：1）仅知识的增加并不足以阻止HIV在IDUs中传播；2）应更加关注HIV由IDUs经性途径向非高危人群传播的可能性；3）同伴教育的基础是IDUs“圈子”和“核心人物”的存在，但也受“圈子”和“核心人物”特点的限制。故其作用不宜高估；4）同伴教育的策略方法应予改进。     

Combining CGM and an Online Peer Support Community for Hispanic Adults with T2D: A Feasibility Study

Background:Previous research has identified that people with type 2 diabetes (T2D) within the Hispanic community would benefit from an online peer support community (OPSC) and continuous glucose monitoring (CGM) data to facilitate diabetes self-management.Methods:A mixed-methods feasibility study enrolled Hispanic, Spanish-speaking adults with T2D, not on insulin. Participants were provided with CGM and access to an OPSC for 12 weeks. Feasibility was assessed by number of eligible participants who enrolled, attrition, quantity of CGM data, validated clinical measures of self-efficacy, quality of life and adverse events. Engagement in the OPSC was measured using objective metrics on the online platform. Qualitative interviews were conducted upon conclusion of the intervention to assess feasibility, acceptability, participant satisfaction, and key recommendations for improvement.Results:Of 46 participants screened, 39 were eligible and 26 completed the study. Participants significantly improved self-efficacy scores. Posts in the OPSC related to goal setting had the highest engagement followed by mid-week and end of week check-in posts respectively. Participant interviews described challenges accessing the OPSC platform as a barrier to engagement. Despite this, all participants were satisfied with the intervention. Key recommendations for improvement included providing greater variety of and individualized education and the use of a peer support platform that is easily accessible.Conclusions:The CGM + OPSC intervention tailored to the Hispanic community with T2D was feasible, acceptable and satisfactory and improved participant self-efficacy for diabetes management which may lead to improved clinical outcomes.     

同伴教育模式下艾灸疗法干预HIV感染者50例临床观察

目的 观察同伴教育模式下的艾灸疗法(简称同伴艾灸)对人类免疫缺陷病毒(HIV)感染者的临床疗效.方法 将100例HIV感染者随机分为试验组和对照组各50例.试验组予同伴艾灸干预,对照组予普通健康教育干预,两组疗程均为3个月,观察期1年,观察两组患者综合疗效和干预前后主要症状体征积分、卡洛夫斯基积分、生存质量评分、CD4+细胞计数变化.结果 试验组综合疗效总有效率为96.00％,对照组为64.00％,试验组优于对照组(P＜0.01).干预后试验组发热、乏力、纳呆、腹泻、自汗、盗汗、症状体征总积分、卡洛夫斯基积分、CD4+细胞计数、生理领域、心理领域、社会关系领域及综合评分明显改善(P＜0.05或P＜0.01),对照组干预后症状体征总积分、卡洛夫斯基积分、环境领域评分明显改善(P＜0.05).试验组干预后发热、乏力、纳呆、腹泻、自汗、盗汗、症状体征总积分、卡洛夫斯基积分、CD4+细胞计数、生理领域、心理领域、社会关系领域及综合评分改善明显优于对照组(P＜0.05或P＜0.01).结论 同伴艾灸能改善HIV感染者的症状体征,提高生存质量,疗效确切.     

The contribution of self‐help/mutual aid groups to mental well‐being

This article explores the contribution of self‐help/mutual aid groups to mental well‐being. Self‐help/mutual aid groups are self‐organising groups where people come together to address a shared a health or social issue through mutual support. They are associated with a range of health and social benefits, but remain poorly understood. This article draws on data from stage one of ESTEEM, a project which runs from 2010 to 2013. Stage one ran from 2010 to 2011 and involved participatory, qualitative research carried out in two UK sites. Twenty‐one groups were purposively selected to include a range of focal issues, longevity, structures and ethnic backgrounds. Researchers carried out 21 interviews with group coordinators and twenty group discussions with members to explore the groups' purpose, nature and development. Preliminary analysis of the data suggested that mental well‐being was a common theme across the groups. Subsequently the data were re‐analysed to explore the groups' contribution to mental well‐being using a checklist of protective factors for mental well‐being as a coding framework. The findings showed that groups made a strong contribution to members' mental well‐being by enhancing a sense of control, increasing resilience and facilitating participation. Group members were uplifted by exchanging emotional and practical support; they gained self‐esteem, knowledge and confidence, thereby increasing their control over their situation. For some groups, socio‐economic factors limited their scope and threatened their future. The article provides an evidence‐base which illustrates how self‐help/mutual aid groups can enhance mental well‐being. If supported within a strategy for social justice, these groups enable people with varied concerns to develop a tailored response to their specific needs. The authors suggest that policy‐makers engage with local people, investing in support proportionate to the needs of different populations, enabling them to develop their own self‐help/mutual aid groups to enhance their sense of mental well‐being.     

The analysis of social network data: an exciting frontier for statisticians

The catalyst for this paper is the recent interest in the relationship between social networks and an individual's health, which has arisen following a series of papers by Nicholas Christakis and James Fowler on person‐ to‐person spread of health behaviors. In this issue, they provide a detailed explanation of their methods that offers insights, justifications, and responses to criticisms [1]. In this paper, we introduce some of the key statistical methods used in social network analysis and indicate where those used by Christakis and Fowler (CF) fit into the general framework. The intent is to provide the background necessary for readers to be able to make their own evaluation of the work by CF and understand the challenges of research involving social networks. We entertain possible solutions to some of the difficulties encountered in accounting for confounding effects in analyses of peer effects and provide comments on the contributions of CF. Copyright © 2012 John Wiley & Sons, Ltd.     

Perceived Benefits of Online Support Groups for Women with Metastatic Breast Cancer

Women with metastatic breast cancer (MBC), a life-threatening illness, stand to benefit a great deal from online support groups, but none have been studied specifically within this population. The present mixed-method study was carried out to determine which therapeutic factors occurred in online MBC support groups, and to see how such factors might have acted to benefit participants. Participants were 20 women with MBC who participated in online peer support groups. Most reported benefiting in some way from their groups. Six therapeutic factors theorized to be helpful in online support groups and cancer support groups were present in the groups studied: group cohesiveness, information exchange, universality, instillation of hope, catharsis, and altruism. However, although participants reported being able to discuss many other concerns freely, they had difficulty discussing death and dying, which are critical issues for this category of women with BC.     

Peer Stress-Related Coping Activities in Young Adolescents' Asthma Management

Managing asthma around peers can be stressful for young adolescents (age 9–14). However, the contexualised coping activities under asthma management-related peer stress is under-investigated. The study aims to explore the peer stress-related coping strategies young adolescents adopt in asthma management. Thirty-four young adolescents were interviewed with semi-structured storytelling protocols. Young adolescents expressed their opinions about four scenarios where the characters had difficulties managing asthma among peers. Interviews were transcribed, and qualitative data were analysed with analytical induction and constant comparison to generate themes that described the coping activities young adolescents adopted in four asthma management scenarios. Young adolescents' responses in each scenario were summarised. The coping activities adolescents adopted were cognitive justifying, explaining, outsourcing and undisclosing. Despite the limitations in a scenario-based qualitative study, the results may be useful for teachers and health professionals in social skill interventions for asthma management in early adolescence.